Is home momitoring of INR safe to do? I would be very convenient to do it at home. Do patients on home mornitoring of INR adjust their dosages of coumadin? Are there specific dosing guidelines that would be safe to do at home? Thank you for any information you can provide on this topic.
There a lot of people using home monitors now for INR. I have not completely bought into yet, but the data suggests it is safe. I would calibrate the INR monitor with a lab -- meaning, have a your INR checked by a lab and make sure the home monitor is close. We recommend the same thing with home blood pressure cuffs.
A physician or trained nurse / pharmacist should still be in charge of dosage adjustments. There is significant risks associated with a INRS that are both too high or too low.
Thanks for posting.
I noticed you had posted a similar question before and included the thread below in case others are interested in the previous post.
I have been off of Coumadin now for about a year, but I did get a home INR machine, with the assistance of my cardiologist, who filled out paperwork/prescriptions for the INRatio INR machine (www.qualityassuredservices.com)and agreed to allow me to call in my results and he would then dose me.
In the paperwork, he had to attest that my INR was unstable, that I had a need to monitor at home (I was 48, had just undergone AV Node ablation for uncontrolled atrial fibrillation, and had other risk factors such as HTN and prediabetes at the time).
Before the first time, he asked me to take my INR to the lab, have them draw the INR via venapuncture and have me take the reading at the same time. The results showed only a .1 difference. My cardio was pleased with the accuracy and for a year, was able to keep my INR between 2-2.5 with consistency.
I took a phone based tutorial/class on how to use the machine and I was set to go.
The machine lists for about $1500; my insurance company at the time paid for it.
Now my machine sits in my closet waiting for the time when I may need to go on Coumadin again.
I was on coumadin for a few mths last year with the cardiomyopathy I had post partum and because I had a prolonged convalescene post C sect and some significant neuromuscular weakness. This was after completing a year on heparin, it would have been so useful to have a home machine, instead of having to visit the labs all the time. I had no idea such a service was available.
I'm so glad you asked the INR question to the Dr. on this board. I never thought to ask what their medical opinion was on the home testing. I have been home testing for about 2 years now. I take my ProTIme machine to the Dr's office and right after having my blood drawn at the lab - I take my own blood test with my machine - to check for accuracy between the two. They say my home test should be done within a half hour of the lab for the most accurate readings. I check my machine with the lab about every 6 mos - unless my INR goes way out of wack and then I test it more often.
I have a "coumadin clinic" that calls me and reminds me to take my INR test the day before its due and to I'm to call them back with the results the following day. They are so good. They adjust the doseage if its to high or to low. I really think coumadin is a drug that is worth taking the extra precaution. I had a Mechanical Mitral Valve inplanted a couple years ago. I have to be 2.5 to 3.5 range. Usually I am - but I have noticed that the first of spring or fall - I tend to go 'up' to high or 'down' to low. Then my doseage is adjusted and I'm back on track. I've heard exercise or lack of exercise can alter the readings - I don't know if its true - but that would coincide with the spring and fall different readings.
I have a friend thats been on coumadin for a good 10 years and she monitors her INR often and she's had no problems. But its defiently a drug that needs close attention. But I've had no problems. Its a pain when I have to go for other surgery as I have to get my INR adjusted before and after the procedure. But that's a minor problem compared to the alternative.
Anyways, I'm glad to see you post that question. I've been off this board for sometime. But popped back on to see what's been posted recently.
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